Paroxetine & Overtraining Syndrome

I guess they were right when they said Paroxetine would cure depression. Maybe not so much actually taking the pills, but looking at them. Contemplating.

Dormant Paroxetine

Weight gain, insomnia, nightmares, "sexual dysfunction" (what exactly does that mean, anyway? - I don't want to find out). I mean come on - it's for people who are depressed to begin with!

In order to avoid putting them in my mouth, I wonder why I have had the recurring episodes of depression. Depression is a relatively new thing for me (since Mattias' birth) and it comes and goes in brief but intense waves. People who grew up with me (Sarah?? - are you there :o)) would have described me as happy and energetic. And I was. And am?

Two weeks ago, I went to the doctor and scored as having a moderate depression on what I believe was called the Hamilton Score - but it's different than the one I find online. I could not stop crying. I had again run the 200 meter intervals that day. I almost threw my iPod Shuffle in the woods on the way home because the music sounded like shit. Cry cry cry. A week later, I went to take the test again (this is required for an official diagnosis) and I was far from depressed. I was embarrassed I had felt so hopeless.

It was following along with Geoff Roes' blog that finally (I think) gave me the answer: Overtraining Syndrome. I can hardly believe I hadn't considered it or had someone suggest it to me. Maybe I thought it was a term made up by non athletes who just didn't "get it". But I have come to realize that if you take training seriously, you should take overtraining even more seriously.

If anything, I had thought Overtraining Syndrome would simply mean you were tired and couldn't perform at your previous level. But most often, the first symptom is depression. And insomnia (estimated to be present in 90% with overtraining syndrome) goes right along with it. Add to this anorexia, and you have the trifecta of Overtraining Syndrome. It seems to originate in overworked muscles that aren't allowed to rest raising cortisol levels and this affecting brain tryptophan and serotonin levels - causing the viscious cycle of insomnia, anorexia and depression listed above, which of course will negatively impact training and things can spiral from there.

Signs that you may have it include an increased resting heart rate and slower return to resting heart rate (I haven't noticed a difference). Cervical lymph nodes also tend to be enlarged as well (you may recall I had mentioned the enlarged lymph nodes in my neck in a recent post). Susceptibility to infection is also mentioned, but not something I personally have experienced. Finally, injuries that heal very slowly (check) if at all.

Here is an article from the British Medical Journal, which I found very helpful: http://bjsm.bmj.com/content/32/2/107.full.pdf+html

The thing that I can't explain is that, in the face of this, I had a dynamite training week. Although for me Christmas meant more calories and more sleep. Plus Ole has had me doing somewhat less intense sessions (I have read 6 min. repeated intervals have the greatest chance of causing overtraining syndrome of anything -and I used to do those every single week). Plus I'm not racing every other weekend like before. More is indeed not more. My mantra is that I need to enter every session feeling fresh and energetic. And I am getting there.

Here my latest training log which I sent Ole. Pretty sure you can get the gist despite the Danish. I'll translate in a few spots.

Lør - 10km på 46.50 udenfor (outside)

Søn- Skodsborg Marathon på trails i Dyrehaven - 37 km på 3.15 og havde masse af overskud og det føltes bare rigtig godt. (der var godt nok mange, som var forvirret over, jeg ikke løb en hel marathon - men jeg var hurtig at meddele, det var din skyld :o)).

Man- spinning

Tirs: 2 + 1.5 + 1 km (genial træning, synes jeg!) - 7.42; 5.45; 3.42 (!). Det var på løbebånd (treadmill) 0,5%. +  mave, baller, lår

Ons: 10km på 46.18 udenfor (igen, føltes nemt og godt) + Bikram Yoga

Tors: 4 x 1 km på banen (the track) (udenfor) gik MEGET bedre end sidste uge: 3.57, 3.54, 3.53, 3.55. Tror nemlig det hjælp at jeg varmede op med (warmed up with) 2 x 200 meter intervaller så hurtigt som muligt. 

Fre: spinning + mave, baller, lår

At this point, my right foot started bothering me because my shoe could not be tied tight enough anymore. I bought some new shoes at Fysium here in Næstved. I adore both the shoes and the store! They look just like my old shoes but logarithmically more comfortable. Wow. I have no idea what that means, but it sounds about as comfortable as they are.

New shoes on bubbleope on radiator = fire hazard

Right now I'm in the middle of an "ultra" training weekend for the Bandera 100k in two weeks:

yesterday: 32 km with SR

today: 28 km

tomorrow: 30 km (? with Annette?)
all on trails in (ok, near) our own back yard.

Running Songs of the Day: (witness taking pleasure in things I normally love)
1. When I See You by Magic Touch & Sapphire Slows
2. Breezeblocks by Alt-J

Finally - for those not friends with me on Facebook yet (or for those who stopped being my friend when I came out as pro gun control), some Christmas pics:

Does this look like a child who was so ill he would keep his parents up all night? Well, it should!  (he's all better,  and we are so relieved)

Top 10 Reads of 2012 - Merry Christmas!

As a sort of electronic Christmas gift (it's the best I can think of!), I thought I'd give you all my list of best reads from this year. Not that they were all published in 2012.

You should know that, it was not for lack of trying that there is only one fiction book listed. I must have started over 20 fiction books and finished one (it's #5 on the list). For example, I was sure I would like Once a Runner by John L Parker, but after a while, I couldn't take it anymore.


10. The Best Norse in the Long Run by Kenny Moore (http://sportsillustrated.cnn.com/vault/article/magazine/MAG1065389/1/index.htm)
A 1986 take on the pregnant marathon and one fast woman.

9. Swim Speed Secrets by Sheila Taormina
For the first time, swimming technique I could understand and see results from.

8. I'm Here to Win by Chris McCormack
The chapters on training and, especially nutrition, are incredibly insightful - and novel. They make the whole book worth it.

7. The Mighty Cobra and the Pink Rabbit: A Diary by Miss Pink
An honest and funny take on Bikram Yoga

6. The Art of Running Faster by Julian Goater
Lots of useful tidbits. SR said he didn't recognize me from the back yesterday at our race because my form has gotten so much better. I think I have this book to thank.

5. The Hours by Michael Cunningham
As mentioned, I rarely tolerate fiction, but I could not put this down. Beautifully written.

4. Eat & Run by Scott Jurek
Reading this was pure joy.

3. Born on a Blue Day by Daniel Tammet
I didn't know it was possible to learn so much about the human mind through one book - about one person.

2. A Life Without Limits by Chrissy Wellington
Read it in 3 days and didn't want it to end. Wonderful book.

1. An Unquiet Mind by Kay Jamisson
Changed my perspective of all psychiatric illnesses and my own life. Not only that, but it is incredibly well-written and a page turner all the way through.

What about your favorites? What did I miss?

Christmas Challenge: Find SR. I'm sure you can find me. Hint: we are both wearing nissehue.

Skodsborg Juleløb 2012. The trails and company in Dyrehaven are amazing.

But my family is the best. We're just about to leave for Chistmas Eve in Værløse. 

I wish you all a safe, healthy and happy Christmas.

Winforce 100km, Solomon 4 Trails & Fyr til Fyr

Every once in a while, I get a really good email. On Monday morning, I woke up to one of these from Christian Madsen from ultrarun.com asking me if I would be the race physician for his Winforce 100k. I got a huge smile on my face, knowing of course I would say yes, but also thinking - WOW. This is not something I have tried before. I immediately contacted physicians who might be in the know about this kind of thing, and have gotten some very good help and advice already. But- if any of you readers have been an official race physician before, I would love to hear you thoughts and advice (heck, even if you're not a physician and you just want to share something).

1. So the Winforce 100km takes place August 17th here in northern Zealand in Denmark. It is a trail race and a qualifier for UTMB (and probably will be for Western States).



I also want to point out that Martin Paldan will be the race photographer and his adventure photography has such an incredible life-like quality.


I chose this one because it reminds me of Christmas lights.

I hope he gets a shot of me stitching up a wicked laceration. Okay - maybe not.

2. But, before that Alicia (of Trails & Rocks fame: http://aliciasrunningandracing.blogspot.dk/ (not working to make this a link!)) , Maria and I are going to be racing in the Alps this July. I mentioned it to coach Ole- and he is okay with it. As long as it is my last ultra before my sub 3 hour marathon attempt - in October?? Salomon 4 trails July 10th-13th. 150km, 10,000 meters alititude change. We're trying to convince SR and Alicia's husband Divesh to join, but SR wants to crew for us and Divesh wants to work on the chemistry of plastics (I kid, Divesh! But it is true.)


3. Also, since we're going in backwards order, SR and I will be running the Fyr til Fyr  60km race on the Danish island of Bornholm April 6th. It is in the Baltic Sea just off of Sweden and to me it sounds like they speak Danish with a Swedish accent. Very endearing.

Here is a map of the race:

Point to point. 60km. Bus to start. All for $40.

So lots of excitement after kicking off the year with the Bandera 100km.

Training with the help of Ole has been going well. I did 5km + 4km on the treadmill in 34:37 on Monday, Wed: 10km in 45:50 + 200 x 6 in 41 sec avg. Thurs: outdoor 1km x 5 track intervals in avg. 4.01. Not fast enough, but I'm faster than last year at this time, which makes me happy.

I told Ole I'm not much for days off, so we're working on the "benfri" (legs free) concept for those days.

For right now, the goal race plan is

Goal race #1: Copenhagen Marathon May 19th - PR
Goal race #2: Milwaukee Lakefront Marathon??  Oct. 6th - sub 3 hours

Christian (middle) with his Icelandic girlfriend, Sigrún and her little sister, Selma. The wedding will be in Mývatn, Iceland. You are all invited.

Song of the day (and the song I keep playing over and over) is Emmylou by First Aid Kit. Thanks to Steve Q for the rec. Here is a beautiful live performance SR found:

Can't keep my mouth shut

Counterintuitive as it seems, living abroad has made me more patriotic. I love the United States: it's beauty, it's originality and probably most of all, it's human diversity. It is a country that has had enormous successes and has such potential to effect positive change.

When I read on Friday what had happened in Connecticut, I was filled with such an extreme sadness. For a moment, I imagined Rasmus and me losing Christian. What would we do? What could we say? I am sure all the moms who read this blog went through this.

Immediately I thought "HOW could this happen AGAIN?" The problem with me is, I expect everyone in the world to look at things like I do - and they don't.

(as I read somewhere about America -  one guy in an aiport had a bomb in his shoe and everyone removes their shoes before boarding a plane; 31 school shootings since Columbine and nothing changes)

I posted something on Facebook about gun control and universal psychiatric care and I lost 14 friends. I couldn't sleep because it had never occurred to me how much I would offend people.

And yet, I continue here.

Can someone please tell me why ít is legal for Americans to buy automatic rifles like those used in Afghanistan? And why, last week, did Michigan legalize carrying concealed weapons in schools? I keep trying to look at it from the point of view of those who want to own guns, but I don't get it. Yet I guess I think like a Dane. I live in a country where possessing a weapon like that or bringing a gun in a school is incomprehensible. But have I become so close-minded in my safe haven that I can't understand the view point of my old grade school friends? Have I changed so much?

Then again, America, why not make owning a home nuclear bomb legal? - then we can all wonder why half of the state of New York disappears when a psychopath gets a hold of one.

But enough on that.

There is something else that I can't let go of. The killer: Adam Lanza. Before we knew anything about him, we knew he was a psychopath. People keep talking about "Aspergers", yet it seems he had no official diagnosis, despite seeming psychiatrically ill to pretty much everyone who knew him. Why are psychiatric illnesses so stigmatizing that no teachers ever referred him for care? What if psychiatric care were free and available to all like it is in Denmark? I can't help but wondering.

Forgive me, but I NEED to pose these questions otherwise I will never forgive myself. I would never forgive myself if I didn't fight for what I believe in and one of my children is killed when we move to the US.

We all believe different things. The most important thing is we stand up for what we believe in, even if we fear it might offend others because it's "political".  No democracy is healthy if its citizens don't stand up for what they believe.

The running coach experience & running for a cause

How's the coaching going, you ask?

Let me put it this way. When I wake up, I never look forward to the run on my schedule. I'm just plain afraid I won't be able to complete my assignment acceptably. I am given distances and times they should be run in. First the snow cover and then the very deep snow cover added an extra level of stress! (I know I should look at this as a privilege to be coached, but if I weren't stressed I wouldn't be enjoying it).

Here's how this last week looked

Thurs: dreading my run. 2 x 4km in 16:00 and 15:57. Felt really hard. CX worx class fit in perfectly after this.

Fri: legs are dead tired. 27 km in 2:27  at Fredskov Marathon. Very hard. Right leg hurting.

Saturday: Rest day! Yay. Went to Copenhagen with the family and got to do a Bikram Yoga class. Met Malene who tried Bikram Yoga because I had mentioned it on my blog!! How cool.

Sunday: don't feel like running. Biggest snow and ice storm in Denmark's history. I think I still have a corneal abrasion on my left eye (it still hurts) from the wind pelting ice. 27 km in a time I will never reveal because I chose to remain ignorant. Perhaps one should never time a long run in 5 inches of fresh snow (it's only just starting in the picture below). This was again at Fredskov Marathon. I can't fathom that Annette has now run over 150 marathons and she just keeps on running in this snow! Nothing short of amazing.

Photo by Ulrich Fredskov

This is how it looked a little later. The thing that does not get conveyed here is how strong the wind was!! Poor us, I know.

Mon: Again, deep snow, 20 miles. Tears were even shed as I ran the first half with SR. (this back to back long run thing is training for Bandera 100k in January)

Tues: cross training (yay!) spinning + step + core

Wed: Looking for ANY excuse not to do the run on my schedule: 3 x 3km in 4-4:15 min/km. I actually did it in 11:52, 11:49 and 11:47. (treadmill, 0.5%)Cool! Way faster than planned and no hip pain. Maybe I should stick to the treadmill. Time for a short swim!

Tomorrow is 1.5 km intervals.I have to admit I'm not 100% dreading it right now.

Now a question (or a lot of questions):

Did you ever want to run and blog to raise awareness for a good cause? Or is this just the naïve idealist talking? The health and safety of long-distance running during pregnancy certainly came to my mind. But there is no existing organization that focuses on that, is there? And what about the health and safety of female runners in 3rd world countries? Is it so unrealistic that there are female runners in poor or politically unstable countries? Do you readers know of any organisations that work with these causes? Or do have have another suggestion of an organization it would make sense for me to bring attention to?

Running song of the day: Secret Days by School of Seven Bells (http://stereogum.com/1189711/school-of-seven-bells-secret-days/mp3s/ ) I guess it makes sense to run intervals to so-called "zero-gravity pop".

And finally. I love my family. (sorry if you already saw these on Facebook)

I fail to see any resemblance here.

Primordial rocks juxtaposed with supersonic green plastic nuk.

Just have to point out that is not OUR refrigerator in the background. Although it is probably all gluetn free.

200 meter interval induces migraine, depression

And just like that , I'm normal again. Breathing normally and finding happiness in my favorite things. 

Looking back, it must have started on Saturday. I woke up feeling actually quite fine and had a good morning. I went out for a 45 min warm-up run before my short intervals and even ran into some friends at the track. On my schedule were 200 meter intervals at between 36 and 40 seconds. I thought this would be impossible. As far as I am aware, I have never run at around a 5 minute per mile pace (and maybe for good reason). To make a long story short, I did it (though barely): times were 40, 39, 39, 40, 40, 39. 

The reason I mention this, is after the second one, I suddenly had such an excruciating headache behind my left eye. I thought I was going to throw up. Certainly any normal person would have stopped, but I rationalized that running more intervals would reverse what had happened, though I was scared of it being an aneurysm.

For those of you who don't know me well yet, hypochondriasism is one of my main hobbies.

All Saturday, that headache did not go away. I had to lay in the dark and close my eyes (let me just point out, I have never had a migraine before, but have imagined this is how one feels). And then the crying started. I said over 100 times that I was dying - of a brain tumor (of course). SR told me to go lie down again. I slept a little and felt a little better.

The next day I woke up really late. Usually I go swimming with the tri club on Sunday mornings, but I had no time for or interest in that. We had also planned I'd run the Herlufsholm 10k race  - and the snow was gorgeous!

And it was a tough race - very hilly and on trails. Despite the snow, I ended up running in 42.17, beating my previous record time on this course (set in warm, dry weather) by almost 30 seconds. But that is neither here nor there. Rather than focussing on it being a good race, I could not let go of the fact that because I have started taking my PPI again (due to my stomach acid causing enormous large lymph nodes in my neck) that my PPI-induced stomach pain ruined my race and limited my running. (ok, that is just an aside)

Later that night, we went to a family party in Copenhagen. Normally I love hanging out with SR's family, but before the night was over, I found myself hiding in a room, crying. Objectively there was absolutely nothing wrong. I just wish I could convince myself of that, though, at the time these things happen. The kids had a great time and of course this should be reason enough for any mom to smile.

That night I had one nightmare after another - all involving cancer. (I was about to ask SR to quit his job!)

There is no point in going through the whole week in great detail. I was just on edge all week, the edge of tears and yelling and I hate that feeling. On top of that my OCD got 10x worse. But last night, after a massage (go figure), my depressive symptoms were gone as quickly as they came. Wow! It is kind of like waking up from a bad dream and you're like - ok, this IS me. I am STILL a happy, normal person.

What is within normal? What is illness? I wish I could stop these "episodes" from ever happening again - and certainly, looking back, I have used running as my medicaion for years, without ever fully realizing that anything was wrong. And maybe nothing is. Maybe it's normal to get a bit depressed as winter rolls around. If you do, you are not alone.